566216262-3-17-2022-17-CC-ARIS-CCLPL6-20220317112413

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566216262
Report Date: 03/17/2022
Date Signed: 03/17/2022 11:24:22 AM

Document Has Been Signed on 03/17/2022 11:24 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	CORTEZ FAMILY CHILD CARE		FACILITY NUMBER:	566216262
ADMINISTRATOR:	ANITA CORTEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 216-2520
CITY:	OXNARD	STATE: CA	ZIP CODE:	93030
CAPACITY:	14	CENSUS: 0	DATE:	03/17/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:59 AM
MET WITH:	Anita Cortez		TIME COMPLETED:	11:37 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	This is a change of location, previous facility number 566211051. Oxnard fire department also did inspection on 3/3/2022 for licensee to continue to be licensed as a large family child care home in the new address. On 3/17/2022 at 10:05 AM, Licensing Program Analyst (LPA) Austin Rios conducted an announced change of location Pre-licensing inspection. LPA conducted a Pre-screening with licensee prior to entering the FCCH. LPA met with licensee Anita Cortez. LPA discussed the nature and purpose of the inspection. LPA toured the home with licensee. The licensee will be using the living room, dining room, kitchen, one bathroom, and backyard for the day care. The bedrooms, laundry room, and garage will be off limits. There were no children in care at the time of the inspection. LPA did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher which was purchased on 6/10/2021 was observed in the kitchen readily accessible. Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed and tested the smoke and carbon monoxide detectors in the home. There are age appropriate toys and day-care equipment in the home. The back yard has age appropriate toys and day-care equipment. LPA advised licensee must provide visual supervision while the children are playing outside in the backyard. Licensee First Aid/CPR certificate is valid until 2/24/2024. Cont on 809 C.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin Rios	TELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CORTEZ FAMILY CHILD CARE	FACILITY NUMBER: 566216262
	VISIT DATE: 03/17/2022

NARRATIVE

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Licensee has firearms in the home stored in a safe inaccessible to children and ammo stored separate. Licensee provided mortgage statement to verify control of property.
LPA verified SB 792 (child care employee and volunteer: Immunization and Tuberculosis Requirements). 1207 Mandated Reported Training Certificate dated 9/2023. Licensee was informed walkers, bouncers, and any similar objects that restricts child movements is prohibited from licensed facilities. LPA spoke with licensee regarding safe sleep regulations.

Incidental Medical Services (IMS) was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at:http://www.ada.gov/childqanda.htm

No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin Rios	TELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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